The IRS has updated the Patient-Centered Outcomes Research Institute (PCORI) fee for self-insured health plans. For plan years ending between October 1, 2025, and September 30, 2026, the PCORI fee is $3.84 per covered life. For plan years ending between October 1, 2024, and September 30, 2025, the fee remains $3.47 per covered life.
Application of PCORI Fee
The PCORI fee, established under the Affordable Care Act (ACA), applies to health insurance issuers and self-insured plan sponsors to fund comparative effectiveness research. Originally set to expire in 2019, the fee was extended and now applies to plan or policy years ending before October 1, 2029.
Payment Deadline
PCORI fees for self-insured health plans must be reported and paid annually using IRS Form 720 by July 31 each year, following the end of the plan year. For plans ending in 2025, the deadline is July 31, 2026. Fees for 2024 plan years should have been paid by July 31, 2025.
Calculating the PCORI Fee
PCORI fees are determined by calculating the average number of individuals covered by the health plan, including employees, spouses, and dependents, unless the plan is structured as an HRA or FSA. Final regulations provide several approved methods for plan sponsors and insurers to accurately determine this average, allowing flexibility based on your plan’s structure.
Download the bulletin for more details.
IRS Resources
PCORI Fee: Questions and Answers
PCORI Fee Due Dates and Applicable Rates
Chart: Application of the PCORI Fee to Common Types of Health Coverage or Arrangements
